In behavioural economics, the goal isn’t always to push harder; it’s often to show what most people are already doing.
When people believe their behaviour is an outlier, they adjust.
When the NHS needed a scalable, low-cost way to reduce missed GP appointments, they didn’t throw money at the problem – they used psychology.
The Behavioural Problem: Patients Skipping Appointments
“Did Not Attends” (DNAs) were a persistent problem for the NHS.
They caused:
- Wasted clinician time;
- Longer waiting lists;
- Poorer patient outcomes;
- Increased system strain.
Traditional approaches used reminders or penalties.
But neither worked consistently – because the barrier wasn’t always intention. It was often perception.
If people believed missing an appointment was common, harmless, or normal… they were more likely to do it.
The Intervention: Use Social Norms to Shift Perception
The NHS trialled a series of SMS messages sent before appointments. One stood out:
“9 out of 10 people attend their NHS appointments.”
That’s it. No guilt. No warnings. No threats. Just a clean, credible social proof nudge.
And it worked – because humans are social creatures.
We take behavioural cues from what others do, not what we’re told to do.
This leverages a principle known as the descriptive social norm: the idea that behaviour is contagious when it feels standard.
The Behavioural Principle: Social Proof
Social proof works best when:
- It’s specific;
- It’s believable;
- It creates a subtle sense of not wanting to be the outlier.
In this case, 91% compliance wasn’t just a stat – it was an identity cue:
“Most people like you do this. You probably should too.”
When reframed this way, the act of missing an appointment becomes the exception, not the rule – and that nudges behaviour without force.
The Result: Measurable Change, Zero Cost
The message led to a 23% reduction in no-shows during trials.
That translated into:
- Tens of thousands of recovered appointments;
- Better clinical efficiency;
- Improved system outcomes – all at near-zero cost.
No apps. No redesigns. No incentives.
Just better framing.
The Takeaway for Business
If your audience isn’t acting, don’t just ask louder. Show them what most people like them already do.
- Product onboarding? Show how many users completed step one.
- Pricing plans? Show which one most customers pick.
- Compliance or reporting? Highlight adherence, not penalties.
People follow the crowd; especially when it feels like their own.
Want to drive better behaviour? Make the right thing feel normal.
